PT - JOURNAL ARTICLE AU - Akshay Dwarakanath AU - Mark W. Elliott TI - Noninvasive ventilation in the management of acute hypercapnic respiratory failure AID - 10.1183/20734735.043812 DP - 2013 Sep 01 TA - Breathe PG - 338--348 VI - 9 IP - 5 4099 - http://breathe.ersjournals.com/content/9/5/338.short 4100 - http://breathe.ersjournals.com/content/9/5/338.full SO - breathe2013 Sep 01; 9 AB - Educational aims To discuss the role of noninvasive ventilation (NIV) in the management of acute hypercapnic respiratory failure in various conditions. To discuss the common problems encountered during NIV. To provide practical considerations for setting up and delivering an optimal NIV service. Summary Noninvasive ventilation (NIV) is considered the standard of care in the management of acute hypercapnic respiratory failure secondary to chronic obstructive pulmonary disease. It can be delivered safely in any dedicated setting ranging from emergency and medical admissions departments to high-dependency and intensive care units. It reduces the demand for invasive mechanical ventilation, decreases in-hospital mortality and shortens hospital stay. The way the NIV service is delivered will depend on the model of hospital care and this varies greatly from country to country. Adequately trained staff and appropriate monitoring facilities, available around the clock, are important. A successful outcome is dependent on good patient selection and the correct implementation of NIV.